title: The use of oral rehydration salt in managing children under 5 y old with diarrhea in the Gambia: knowledge, attitude, and practice.
abstract: OBJECTIVE
  Diarrhea is a leading cause of mortality in children under the age of 5 y in developing countries. To our knowledge, no other studies have investigated the management of diarrhea in the Gambia. The aim of this study was to assess maternal knowledge, attitude, and practice in the causes, prevention, and management of diarrhea in children under the age of 5 y in the Gambia.
  
  
  METHODS
  Four hundred mothers with children who have diarrhea and are under the age of 5 y were randomly recruited. Data were collected using structured questionnaires, including demographic information, knowledge about diarrhea, attitude toward the management of diarrhea, and practice for the prevention and management of diarrhea. χ(2) and Student's t tests were used for the descriptive and quantitative analysis, respectively. Simple and multiple linear regressions were used to determine the association between the variables. A P-value < 0.05 was considered statistically significant.
  
  
  RESULTS
  The mean of maternal knowledge (K), attitude (A), practice (P), and knowledge-attitude-practice sum (KAP) scores were 14.4, 6.3, 13.2, and 33.9, respectively. The mean of knowledge scores were significantly higher in mothers who responded positively for germs (13.4 versus 12.6) and dirty hands (13.7 versus 13.0) as causes of diarrhea. Mothers with education had significantly higher knowledge (14.7 versus 14.2) and attitude scores (6.6 versus 6.1) in management of diarrhea. However, the study found a low use rate (4%) of oral rehydration solution in practice. Multiple linear regression analysis revealed that maternal age was positively associated with practice (β = 0.061) and KAP scores (β = 0.102). The number of children in the family was positively correlated with attitude scores (β = 0.408). Socioeconomic status was positively associated with attitude (β = 0.549), practice (β = 0.841), and KAP scores (β = 1.887).
  
  
  CONCLUSIONS
  The mothers have high knowledge scores in the management of diarrhea; however, use of oral rehydration solution is low among children with diarrhea under the age of 5 y in the Gambia. Higher maternal age and socioeconomic status are correlated with higher practice and KAP scores.
authors.affiliation: School of Nutrition and Health Sciences, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan; Ministry of Health and Social Welfare, Quadrangle, Banjul, The Gambia, West Africa.
authors.forename: Famara
authors.initials: F
authors.lastname: Sillah
authors.forename: Hsin-Jung
authors.initials: HJ
authors.lastname: Ho
authors.forename: Jane C-J
authors.initials: JC
authors.lastname: Chao
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D003906:Developing Countries; D003967:Diarrhea / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005714:Gambia; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009035:Mothers; D012923:Social Class; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Attitude; Childhood diarrhea; Knowledge; Mothers; Oral rehydration solution; Practice